Vol 9, No 2 (2017)

Reviews

НIGH-RENIN HYPERTENSIONS: FROM SYMPTOM TO dIAGNOSIS

Barsukov A.V., Korneychuk N.N., Shustov S.B.

Abstract

The article highlights the current understanding of renin-angiotensin-aldosterone system function- ing, as well as mechanisms for blood pressure raising depending on its activity. Authors presented data on the prevalence and characteristics of arterial hypertension with high levels of renin. Along with high-renin essential hypertension authors considered secondary arterial hypertensions accompanied by high-renin status increasing the diagnostic value of this hormone determination and explains the fea- tures of pathophysiological processes occurring in patients’ organism. Authors proved the importance of renin status diagnostic studies allowing defining a successful strategy of antihypertensive therapy.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):7-18
pages 7-18 views

FROM PATHOLOGICAL PROCESSES TO PATHOGENESIS OF MEdICALLY ALLERGY

Mavlyanov I.R., Ashirmetov A.H., Mavlyanov Z.I.

Abstract

. In modern medicine huge interest causes the analysis of the nature of allergic diseases from positions of a complete organism. Are given total approach to an assessment of pathogenesis of an allergic disease which gives the chance to understand a number of situations which can be observed in the field of practical allergology in the present article. It is known that the sensitization of an organism can be shown to different factors (allergens) as rather exotic on the properties which aren't possessing any specific characteristics, that is symptoms of an allergic state can be shown and regardless of a type of allergen. Any allergic state needs to be considered through a prism of reaction of all organism which level is reflection of its reactivity. That is why symptoms of an allergy need to be considered as addi- tional protective mechanisms which turn on in regulation of a homeostasis at certain, often not shown clinically insolvency drainage дезинтоксикационных functions of an organism.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):19-27
pages 19-27 views

CLINICAL ANd IMMuNOLOGICAL CHARACTERISTICS POSTOPERATIVE PERIOd AT HEMIFACIAL ALLOGRAFTS AVASCuLAR SKIN FLAP

Hurtsilava O.G., Voloh M.A., Lila A.M., Aksenova S.A.

Abstract

In an experiment on rats Wistar family and dark Agouti immunological status of recipients has been studied with facial allograft skin flap in the early and late postoperative periods. The evaluation of the state of the transplant and the general condition of the recipient rats after surgery immunosuppressive therapy.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):28-34
pages 28-34 views

ASSESSING THE POSSIBILITY TO APPLY THE FIBRIN GLuE BY CORd BLOOd PLASMA AS A SCAFFOLd FOR MESENCHYMAL STEM CELLS TRANSPLANTATION

Enukashvily N.I., Aizenshtadt A.A., Bagaeva V.V., Supilnikova O.V., Ivolgin D.A., Maslennikova I.I., Novikova S.V., Adylov S.F.

Abstract

Mesenchymal stem cells (MSCs) and pre-chondrocytes (MSK-Ch) derived from them are an ef- fective tool for the restoration and maintenance of joint cartilage. This approach is based on the use of MSCs as a) chondrocyte precursor to form a cartilaginous implant, b) producing a large number of bioactive factors in the area of implantation. delivery of MSC and MSC-Ch into the damaged joint can be achieved by the implantation of scaffold with cells to ensure retention of the cells at the injection site and an additional supply of cells of biologically active substances.Scaffold based on fibrin glue (FG) are promising because of the high biocompatibility, biodegrad- ability, ease of use. FG cryoprecipitate of autologous plasma (Au-FG) patient or allogeneic umbili- cal cord blood plasma (uCB-FG) in some cases may be regarded as a preferred embodiment of ready commercial products. The advantages of the Au-FG are to minimize the side effects, risks of infection and the occurrence of allergic reactions, availability and reduced cost of the procedure. uCB-FG is enriched with biologically active substances and derived from byproduct during collection stem cells from the cord blood.We have developed a protocol that allows to obtain FG in a closed system throughout the entire process of blood sampling until the transplant procedure, which makes it possible clinical application of the Au-FG and uCB-FG. Also shown that cultivation in Au-FG and uCB-FG does not change the immunophenotype of cells and the level of their proliferation and has a stimulating effect on chondro- genic differentiation.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):35-43
pages 35-43 views

FEATURES OF LEFT VENTRICLE DIASTOLIC FUNCTION IN PATIENTS WITH NON Q-WAVE MYOCARDIAL INFARCTION AFTER PERCUTANEOUS INTERVENTION

Khomyakova D.A., Sayganov S.A., Grishkin Y.N.

Abstract

Aim: To make natural development more exact to state the value of scientific prognostication of dia- stolic dysfunction with acute myocardial infarction without Q-wave after percutaneous intervention.materials and methods: 95 patients were subjected to coronography and revascularization of in- farct-related artery. The patients were divided into 2 groups depending on angiographic results with single and multivessel affection. during first 48 hours from the beginning of the disease they were under ECHO examination.Results: Left ventricle affections dF data were revealed relatively to heaviness of affection in cor- onary vessels without reliable differences in local and global contractility. Primordialy the 1 group contained 14 (54%) patients of I grade dd, 5 (19%) with II grade, 1 (8%) with III grade, 6 (19%) without dd. A year later: 18 (70%) with I grade dd, 3 (12%) with II, patients with III grade were not redictered, 5 (18%) without dd. In group 2 within first 48 hours 37 (54%) patients had I grade,25 (36%) II grade, 7 (10%) III grade. In a year there were 46 (67%) with I grade, 13 (19%) II grade, 3 (4%) with III grade dd, 7 (10%) without dd.Conclusions: Obtained data indicate of a higher sensitivity dependently dF ischemia.In contrast to myocardial infarction group with coronary bloodstream fully restored within short terms, in group with multivessel affections a more heavy dd data preserved longer, in spite of infarct related artery revascularization. Also unfavourable events were revealed.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):44-50
pages 44-50 views

REMOdELLING OF THE LEFT ATRIAL AT THE PATIENTS WITH ATRIAL FIBRILLATION IN VARIOuS METHOdS OF SINuS RHYTHM RECOVERY

Gromyko T.Y., Sayganov S.A.

Abstract

Aim. To compare features of straight and return remodeling of the left atrial (LA) at patients with atrial fibrillation (AF) at various options of sinus rhythm (SR) restoration depending of a choice of the cardioversion. Material and methods. We examined.153 patients with the nonvalvular AF lasting from24 hours to 6 months. All patients were divided in 3 groups. In group 1 (49 patients) SR was restored medically, in the group 2 (57 patients) SR was restored by means of electrical cardioversion (EC), in the group 3 (47 patients) underwent radio-frequency isolation of pulmonary veins (RFI PV). Echocardiog- raphy was performed to all patients at the time of AF, and also on 1, 3, 5, 15 days and in 6 months after recovery of SR with an assessment systolic and the diastolic function of left ventricle (LV), thickness of walls of a myocardium, the front and back size of the LA, volume of LA, and also design parameter of LA pressure (E\E’) by Tissue doppler visualization.Results. Index LA (ILA) authentically decreased at the patients, who are exposed to RFI PV, at preservation of SR compared with recurrence of AF for 6 months (р<0,05). In group of medical therapy index of volume LA (IVLA) initially it was authentically lower at patients with resistant SR for 6 months, compared with recurrence of AF (р<0,05). And also IVLA authentically decreased in group RFI PV without paroxysms of AF for 6 months (р<0,001). At the medical cardioversion LA pressure (E\E’) authentically decreased by 2 weeks (р<0,05) without paroxysms of AF and significantly didn't change by 6 months. While in the presence of paroxysms of AF for 6 months only the tendency to de- crease of this parameter was noted. And in group of RFI PV reliable dynamics of pressure in LA was recorded at patients without paroxysms of AF by 2 weeks (р<0,05) and by 6 months (р<0,05). While in the presence of paroxysms of AF this parameter significantly didn't change by 6 months. In the group of EC reliable dynamics of the estimated parameters of LA remodeling isn't detected.Conclusions. At patients with AF after cardioversion and without paroxysms of AF for 6 months LA sizes authentically decrease in group of medical therapy (IVLA, (р<0,05)) and at RFI PV (ILA, (р<0,05), IVLA (р<0,001)). LA pressure (E/E’) could be considered as a reliable parameter of the return remodeling of LA after cardioversion and without paroxysms of AF for 6 months in cases of medical therapy (р<0,05) and RFI PV (р<0,05).
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):51-59
pages 51-59 views

POTENTIAL ROLE OF INTRAVITAL ARTERIAL EMBOLOGENIC THROMBI ON CARDIO-VASCULAR CATASTROPHIC EVENTS ACCORDING TO POSTMORTEM INVESTIGATIONS

Melnikov M.V., Sotnikov A.V., Vinnichuk S.A., Melnikov V.M., Korostelev D.S.

Abstract

Aim. The purpose of our study was to value the role of potential arterial emboli sources in death cause according to postmortem data collected in deceased from all causes in a multifield hospital.Material and methods. We performed retrospective analysis of 1324 postmortem records of died pa- tients for the past 6 years (2011-2016). We registered patients’ age and sex, thrombus site, definite intravital clinical and anamnestic data, individual features of tanathogenesis.Results. Intravital thrombus formation was found in 64 of died patients (4,8%), mean age 73,9±2,7 years, women 51,5%. In 41 patients (1 group) there were firm wall thrombi in aorta, in 23 patients thrombi were found in heart cameras (2 group), mostly in left atrial appendage (LAA). Generalized atherosclerosis presented more often in 1 group - 95,5% vs 39,1 in 2 group (p<0,005). The most com- mon cause of death in both groups was acute myocardial infarction. In 1 group infarction was often in combination with acute blood supply disturbances in various arterial regions. For deceased of 2 group thromboembolic fatal events were more typical.Conclusion. It was found that the most dangerous thrombi regarding thromboembolic events were intracardiac ones, mainly in LAA. Aortic wall thrombi have become the marker of generalized athero- sclerosis. The last ones predetermined high probability of ischemic complications in multivessel areas.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):60-66
pages 60-66 views

DIAGNOSTIC AND SURGICAL TREATMENT OF ACUTE DESTRUCTIVE CHOLECYSTITIS IN PATIENTS WITH SUB- AND DECOMPENSATED CARDIOVASCULAR DISEASES

Gurtskaya L.Z., Kokhanenko N.Y., Lugovoy A.L., Danilov S.A., Ivanov A.L., Morozov E.A.

Abstract

The work presents the indications for the choice of methods of diagnostic and surgical treatment of acute cholecystitis in patients with decompensated cardiovascular diseases. When covering the possibil- ity of diagnostic methods, their specificity and sensitivity. detailed characteristics of such instrumental techniques as ultrasonography, magnetic resonance cholangiopancreatography, magnetic tomography, echocardiography, electrocardiography, diagnostic laparoscopy has been given. The role of specific bio- chemical markers of myocardial necrosis has been showed: kretinfosfokinaza, cardiac troponin-I. Pos- sible changes on the electrocardiogram in these patients with acute cholecystitis and reasons for their appearance have been described.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):67-72
pages 67-72 views

PROGNOSTIC VALUE OF SOME INDICES OF LIFE QUALITY IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE IN CORRELATION WITH INFLAMMATORY STRESS MARKER

Kostenko V.A., Skorodumova E.A., Skorodumova E.G., Rysev A.V., Dymnikova N.A.

Abstract

The article describes the study of the quality of life in patients with acute decompensated heart fail- ure and comparison of data and a visual analogue scale of Kansas questionnaire in patients with acute decompensated heart failure and also their correlation with known prognostic factors such as level of inflammatory stress markers. Since there can not be a 'gold standard' profiles, their validity can be estimated taking into account the coefficient of correlation data profiles with the prognosis. To assess the quality of life parameters, a Kansas questionnaire was used. Each item was evaluated by patients in1 to 6 points.. Prognostically unfavorable in the questionnaire were the marks from 1 to 3. According to the results of the study, it was shown that the QOL questionnaire can serve not only as a marker for assessing the patient's treatment, but also as an indicator of the medium-term vital prognosis. Correla- tion of these parameters of QOL with objective parameters reflecting the function of the left ventricle, comorbid status (primarily, the state of the kidneys), as well as signs of inflammatory stress are noted.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):73-77
pages 73-77 views

SWEAT AND FAT TRACES OF THE PERSON AS OBJECT OF DNA IDENTIFICATION OF THE PERSONALITY

Faleeva T.G.

Abstract

In the review possible sources of dNA in sweat and fat substance are provided, and skin of the person is considered not only as a source of biological allocations, but also as a specific surface on which there is a possibility of detection of foreign imposings of a biological origin. The analysis of the existing methods of detection, fixing, collection, transportation and the subsequent molecular and genetic research dNA-containing of sweat and fat substance of the person is carried out. Approach to interpretation of results of genotyping of the biological objects containing small amount of genetic material is determined.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):78-84
pages 78-84 views

PECULIARITIES OF DEVELOPMENT OF BEHAVIORAL FUNCTION IN CHILDREN WITH DIFFERENT TYPES OF FEEDING UNDER STRESSFUL CONDITIONS

Ershova I.B., Shirina T.V., Goncharova T.A.

Abstract

The aim of the research is to study the state of behavioral function in infants who were born and living in the Lugansk and donetsk during the military conflict. A dynamic clinical examina- tion was made. Also it was made the assessment of the rate of behavioral development in 68 children in the area of military conflict. Among them 32 children were breast-fed, forming Ia (the main) group of children, and 36 children who were bottle-fed, forming the comparison group Ib. The control groups of our study consist of 88 children who were outside the zone of military conflict. Among them there were 47 children who were breast-fed (IIa group), and 41 children who were bottle-fed (IIb group). The assessment of the level of behavioral function development in children was carried out using a standard- ized clinical-psychological techniques "Gnome".Conclusions: The development of behavioral functions in infants and toddlers depends on the sur- rounding stressful conditions and the type of feeding. The level of formation of these functions in chil- dren who were bottle-fed and under stress of war was the lowest. The greatest delay in children of this group were the indicators of social development. From biological indicators much more suffered the functions associated with eating behavior. Children who were bottle-fed in the stress of military actions in infancy and early childhood are in need of rehabilitation activities.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):85-89
pages 85-89 views

VERIFICATION AND TREATMENT OF RESISTANT CHRONIC RHINOSINUSITIS WITH NASAL POLYPS AT MULTIMORBID CARDIOVASCULAR PATHOLOGY

Aflitonov M.A., Artyushkin S.A., Partsernyak S.A., Mironenko A.N., Partsernyak A.S., Naumov S.Y., Bezrukova E.V., Topanova A.A.

Abstract

Objective: Identify the diagnostic signs for chronic rhinosinusitis with nasal polyps (CRSwNP & resistant forms) with multimorbid cardiovascular pathology (MCVP) (coronary artery disease (CAd), hypertension, metabolic syndrome (MS). Identify effectiveness of photodynamic therapy in CRSwNP treatment. Design and methods: The study included 75 patients (mean age 35,8±7,93, 39,2% - female,60,8% - male) with CRSwNP and MCVP divided into 3 groups by simple random sampling. Patients in group 1 (n = 27) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks anti- bacterial and leukotriene receptor antagonists treatment. Surgical interventions history of the last 5 five years: from 1 to 2. Patients in group 2 (n = 28) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks antibacterial and leukotriene receptor antagonists treatment. Surgical inter- ventions history of the last 5 five years: more than 3. Patients of group 3 (n = 20) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks antibacterial treatment, 8-weeks leukotriene receptor antagonists treatment and sessions of photodynamic therapy of the paranasal sinuses. Surgical interventions history of the last 5 five years: more than 3. used in the study: complex psychological test methods, ENT and laboratory-instrumental evaluation of the cardiovascular system. Results: depres- sion was detected in 46,3%, 71,9%, 58,3% of patients, (first, second, third groups). Types «non-dipper» and «night-peaker» found in patients 2nd and 3rd groups- corresponds with (CRSwNP & resistant forms). Bone transformation zone as a result of chronic inflammation within the ethmoidal labyrinth and maxillary sinuses identified in the second and third patients group (85% of cases). The use of pho- todynamic therapy in the resistant CRSwNP forms treatment improves the functional indicators of the nasal cavity and paranasal sinuses. Conclusions: Patients with CRSwNP have symptoms of depression and «non-dipper» and «night-peaker» patterns. All CRSwNP patients are defined trigger points with areas of chronic osteitis and odontogenic osteomyelitis. The use of photodynamic therapy for CRSwNP treatment, reduces the number of CRSwNP recurrence.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):90-96
pages 90-96 views

PRINCIPLES OF FORMATION IN THE POPULATION HEALTH SAVING BEHAVIOR BASED ON COMPETENCE-ACTIVE APPROACH

Zelionko A.V., Luchkevich V.S., Avdeeva M.V., Filatov V.N.

Abstract

The article presents the characteristics of the main risk factors and shows the need to involve the family, educational and medical resources, depending on the features of risk factors affecting different stages of human life. It was found that high medical awareness does not affect negotiability of citizens in medical institutions and adherence to a healthy lifestyle. The high frequency of individuals (35.1%), knowledgeable about the principles of health preservation and able to carry them out, but do not applying their medical knowledge and skills in practice, was revealed. One of the ways to improve adherence of health saving behavior of the population is a dynamic monitoring of the implementation of health recommendations according to the primary accounting documents.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):97-102
pages 97-102 views

DEVELOPMENT OF AN AUTOMATED WORKPLACE OF THE DOCTOR-SPECIALIST IN DERMATOLOVENEROLOGY

Kupeeva I.A., Raznatovsky K.I., Ravodin R.A.

Abstract

In the article the questions of creation of the automated workplace (AWP) specialist doctor are considered. On the example of development of the automated workplace of the dermatoven- erologist shown its functionality and ways of interacting with other structural elements in the provi- sion of dermatological care to the population. On the basis of the developed automated workplace the algorithm of work of the dermatovenerologist is offered
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):103-108
pages 103-108 views

USING QUALITY EVALUATION CRITERIA FOR EDUCATIONAL SERVICES IMPROVEMENT IN THE CHALLENGING POST-GRADUATE MEDICAL EDUCATION CONDITIONS

Rizakhanova O.A., Melnikova E.A., Filatov V.N., Gonchar N.T.

Abstract

The article is devoted to the research of evaluation criteria of the educational services' quality and search possibilities of these criteria analysis influence on educational process improvement. The work presents theoretical analysis of the problem of assessment of the quality of education in the conditions of additional professional education system reform in Russia. The article presents data from retrospec- tive analysis of questionnaires from the trainees of the department of Public Health, Economics and Management in Health Care System on the questions, related to the quality of educational process in the frame of the post-graduate training courses and primary professional education. The work presents retrospective analysis of the education quality assessment based on the testing methods of professional competencies of trainees. Approaches towards educational process, proposed in the research, aimed to help in the objective assessment of the readiness of the suppliers and end-users of educational services in the professional medical additional professional education to implement new forms of education in the conditions of the challenging professional education in Russia.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):109-113
pages 109-113 views

EFFICIENT TREATMENT TO BETA-AMYLOID VASCULITIS

Golovkin V.I., Ovdienko O.A., Tikhonova M.L., Gulak D.A., Zhulev S.N.

Abstract

The article contains own observation beta-amyloid cerebral vasculitis (associated with cerebral amyloid angiopathy), a diagnosis using the MRI gradient echo mode, immunoassays for the mainte- nance of serum amyloid, interleukin-1, intrathecal antibody synthesis and immunosuppressive treat- ment metipred and azathioprine positive result.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):114-116
pages 114-116 views

EXTRAPONTINE MYELINOLYSIS: CLINICAL AND IMMUNOLOGY FEATURES ONE CASE

Lobzin S.V., Golovkin V.I., Ephymov I.M., Timonina O.I., Garishina J.O.

Abstract

The article presents clinical observation of a rare form of demyelinating diseases of the brain - ex- trapontine of myelinolysis, a feature which was detection of intrathecal synthesis of light chains of im- munoglobulins.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):117-120
pages 117-120 views

FEATURES OF COLON DIVERTICULOSIS LATE COMPLICATIONS SURGICAL TREATMENT

Zemlyanoy V.P., Sigua B.V., Nikiforenko A.V., Latariya E.L., Sharvadze K.O., Dadalov S.A.

Abstract

Diverticular disease of the colon is frequent bowel disease. Wide spread of this pathol- ogy, especially among elderly patients, is caused by characteristics of the diet in developed countries. In modern conditions the clinician is faced with the complicated forms of diverticular disease, in some cases requiring urgent surgical intervention. However, the frequency of diagnostic errors on the back- ground of complicated diverticular disease can reach significant values. A clinical case, indicating the significant difficulties, appearing while diagnosis and surgical treatment of diverticular disease late complications is exampled.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):121-124
pages 121-124 views

OCULAR DIROFILARIASIS CASES IN A TEMPERATE ZONE

Zumbulidze N.G., Khokkanen V.M., Kasimov F.O.

Abstract

Over the last years, there is a pronounced tendency of increase in number of dirofilariasis infected animals and humans in the temperate climate area. In the article, four clinical cases of ocular dirofila- riasis are presented, diagnosed in ural and North-Western Regions of the Russian Federation. upon larvoscopic examination, dirofilaria Repens immature female was identified in all cases.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):125-130
pages 125-130 views

THE WAY OF RECONSTRUCTIVE SURGERY IN CHRONIC DUODENAL ULCER, COMPLICATED BY BLEEDING WITH SEVERE BLOOD LOSS AFTER RETROCOLIC GASTROJEJUNOSTOMY

Sigua B.V., Zemlyanoy V.P., Danilov A.M., Klimov S.E., Romanenko O.A., Rodin A.O.

Abstract

Currently, surgical treatment of gastrointestinal bleeding is based primarily on topical preoperative identification of their source. In this regard, the treatment of patients with bleeding from unknown sources is a difficult task and is accompanied by a high mortality rate. In such cases, in the absence of confirmation of gastrointestinal bleeding source, treatment should base on the clinical pic- ture. A successful case of surgical treatment of patient with chronic duodenal ulcer, complicated with bleeding after retrocolic gastroenteroanastomy is described.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(2):131-134
pages 131-134 views


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